Highlights from the 2016 NCRI Winter Meeting – 21 January 2016, London

Highlights from the 2016 NCRI Winter Meeting, Thursday 21 January 2016, London

The 2016 NCRI Winter Meeting brought together NCRI Trustees, senior representatives from NCRI Partner organisations, industry stakeholders, patient representatives (also known as ‘consumers’ within NCRI), and other key stakeholders in the field of cancer research. It is one of two annual meetings that provide people the opportunity to catch-up on NCRI’s work and steer the future direction through shared insights and ideas. This meeting focused on NCRI’s core activities – those that help us to form the ‘big picture’ of UK cancer research; our Clinical Studies Groups (CSGs), Cancer Clinical Trials Unit (CTU) Group, the NCRI Cancer Conference and CaRD, our cancer research database.

The full-day meeting had a packed agenda that also included guest speakers Steven Wooding from RAND Europe, Sean Duffy from NHS England, Virginia Acha from the Association of the British Pharmaceutical Company (ABPI), Richard Stephens, NCRI Consumer Lead and Emma Greenwood, Head of Policy Development at Cancer Research UK. They updated attendees on current issues and trends within cancer and the wider field of research; from industry and consumer insights, to updates on implementing the Cancer Taskforce recommendations and some top lessons for making research funding decisions. Cancer Research UK and Breast Cancer Now also shared insights into their research strategies. The meeting was chaired by NCRI Chair, Delyth Morgan.

Read on for highlights of the meeting.

NCRI core activities

NCRI’s four core activities are long-standing and central to our purpose of promoting collaboration in cancer research to enable faster progress for the benefit of patients and the public. Each core activity coordinates a range of people and insights and enables us to gain strategic oversight in order to support cancer research in the UK. A summary of core activity updates discussed at the meeting are below.

The NCRI CSG portfolio maps are a visual representation of NIHR CRN’s cancer clinical studies. They are an important tool for clinicians and the wider research community to see the cancer clinical studies within the NIHR CRN that are either preparing to open for patient recruitment or are actively recruiting. They also help to highlight gaps in the portfolio, meaning that CSGs and the wider research community can work together to plan studies to fill these gaps. Meeting attendees were shown the new interactive dashboard that allows easy navigation of the maps, and enables tailored searches (e.g. by study status – open for recruitment or in set-up; by funding type – academic, industry or partnership; by study phase – from pilot/feasibility, all the way through to phase IV clinical trials). They were also shown how more detailed trial information can be obtained: each study is linked to the UK Clinical Research Network Portfolio Database, the single information system that holds data on research activity for clinical studies supported by the research networks in England (the NIHR CRN), Northern Ireland, Scotland and Wales, and this information can be accessed from the maps with a single click.

In 2014 the NCRI launched the NCRI Study Concept Registration scheme as a way to initiate collaborative discussions around new and developing cancer clinical study concepts that are being developed by CSGs or its Subgroups. Through this online system the study proposer registers the study with the NCRI Executive, giving information on patient population and main outcome measures. The NCRI Executive then ‘match-make’; seeking input from members of other CSGs, Subgroups and relevant NCRI activities on ways to further develop the study concept into a high-quality research proposal. NCRI’s Clinical Research Director, Professor Matt Seymour, updated attendees on the use of the scheme: so far 48 study concepts have been registered with the scheme and these have received input from over 80 people, including members of CSGs, Subgroups, other NCRI working groups, the European Organisation for Research and Treatment of Cancer (EORTC) and the International Rare Cancers Initiative (ICRI).

Meeting attendees were given an update of the ways in which NCRI are partnering with Public Health England’s National Cancer intelligence Network (NCIN) to promote the use of data that are routinely collected in the NHS (and brought together by the NCIN) amongst the cancer research community. NCRI CSGs got a particular mention as several CSG members are working with the Genomics England Clinical Interpretation Partnership domains to ensure effective sharing of research expertise in the 100,000 Genome Project.

Meeting attendees heard how the NCRI CSGs have been working to implement a system to flag potentially practice-changing clinical trials that are approaching the time for analysis and reporting of their primary endpoint to the National Institute of Clinical Excellence (NICE), NHS England and health boards for the devolved nations. This will enable beneficial new treatments or approaches to be incorporated into clinical practice at an earlier stage, and is a project that addresses recommendation 53 of the Cancer Taskforce report.

Professor Judith Bliss, Director of the NCRI Cancer CTU Group, provided meeting attendees with an update of items discussed at the NCRI Cancer CTU Group’s inaugural meeting last January. The meeting brought together the Directors and Operational Leads of the 15 member CTUs to discuss key issues in cancer clinical trial design and delivery and to identify the priority areas of focus for the Group in the year ahead. For the CTU Directors, the areas of focus included: exploring the potential of big data e.g. using routine clinical data collected in the national cancer registry to enable effective follow-up of patients in trials; exploring efficient ways to approach contemporary issues in cancer clinical trials e.g. adaptive designs, increased use of multiple novel agents, changes in regulatory framework; increasing interaction with the NCRI CSG Chairs; considering the appropriate costing of clinical trials and sharing experiences of cost models; developing best practice for working with industry. For the CTU Operational Leads the areas of focus included: sharing experience of interactions with the Medicines and Healthcare products Regulatory Agency (MHRA) e.g. inspections and applications for clinical trial authorisation; sharing experience of managing trials with international sponsorship; developing best practice for working with industry. Since the inaugural meeting last year, the Group’s CTU Directors and Operational Leads have each met twice to take forward discussions on these priority areas. Progress in these areas will be assessed as part of the Group’s annual review process in the summer.

One of the key priority areas for focus identified by the NCRI Cancer CTU Group at their inaugural meeting was to develop ways of working with industry in the design and delivery of non-commercial clinical trials. Industry partners, such as pharmaceutical and biotech companies, play a valuable role in non-commercial trials through provision of grants and access to new and innovative therapies for testing. Meeting attendees discussed the Group’s recent discussions around ways for non-commercial trials to gain earlier access to promising therapies in a company’s drug development library and how the Group are working to ensure that all CTUs are working in a consistent manner in response to industry requests for access to clinical trial data.

The NCRI Cancer Conference brings a broad range of people together, at all career levels. Meeting attendees received an update on last year’s delegate numbers and demographics. They heard that Conference delegates included clinical personnel, PhD students, industry, exhibitors and consumers and that engagement was supported by a diverse programme, ranging from prevention, diagnosis and treatment through to health service research, informatics, survivorship and end of life care.

The Chair of this year’s NCRI Cancer Conference Scientific Committee, Professor Caroline Dive, provided meeting attendees with an update on the development of this year’s programme. So far there are 12 plenary sessions, 8 symposia, 6 workshops and 22 parallel sessions confirmed. Plenary talks will include: the yeast cell cycle (Ian Hagan), immunotherapy (Lipeng Chen), radiobiology and prostate cancer (Rob Bristow), APOBECs and relevance to cancer (Reuben Harris), non-small cell lung cancer (Mark Krasnow) and cancer, immunology and the microbiome (Jennifer Wargo). And, as the first female Chair of the Conference, Professor Dive was especially pleased to announce that one of the workshops will be focused on celebrating women in science. She reported that although the programme for 2016 is nearly finalised there are opportunities to submit suggestions for future Conferences. The Scientific Committee consider programme suggestions from within the NCRI Partnership and the wider research community; suggestions can be submitted via the link below.

NCRI’s Head of Conference and Events, Nicole Leida, provided meeting attendees with a summary of key findings from a consultation with NCRI Partners on the future of the Conference. The important role that the Conference plays in inspiring collaboration and partnership working and in showcasing high-quality research across the cancer research spectrum was widely acknowledged. Other valuable aspects identified were the abundance of networking opportunities, the active involvement of consumers and the Conference’s role in inspiring a younger generation of researchers through the School’s Event. In terms of suggestions for further development, several ideas were brought forward, including: exploring other location options; compressing the programme in to three full days (instead of two full and two half days); working closely with industry in order to ensure the Conference remains relevant to these key stakeholders; further raising the profile of research that is presented at the Conference through publications e.g. conference proceedings in a peer-reviewed journal. All these ideas will be considered as part of the ongoing development of the Conference, to ensure it continues to inspire and promote collaboration in cancer research.

As well as tracking and analysing trends in research spend, NCRI Partners have previously expressed an interest in exploring the potential of linking the data in CaRD to research outcomes data, therefore enabling the outputs and impact of the research funding recorded in the database to be assessed. NCRI’s Research Analyst, Dominic Dwyer, summarised the findings from a recent consultation with NCRI Partners, which were that, whilst there is potential for this approach in the future, more time was needed for the use of research outcomes collection and evaluation tools such as ResearchFish® to become embedded in practice and to accrue a high quality dataset that could be linked to CaRD data. NCRI will therefore continue to consider this approach and other ways in which CaRD can continue to add value e.g. through use of automated data collection and coding technology to enable more focus of resource on analysis.

The International Cancer Research Partnership (ICRP) is a unique alliance of cancer organisations working together to enhance global collaboration and strategic coordination of research. ICRP’s Operations Manager, Lynne Davies, provided meeting attendees with an overview of ICRP and its activities. NCRI is the UK member of this partnership, which also includes cancer research funders from USA, Canada, Europe, Japan and Australia. The ICRP database contains funding information on over 76,000 grants, totalling over $50bn on cancer research since 2000 and through this partnership NCRI and its individual Partners are able to view their funding in an international context. The ICRP operates through regular teleconferences and an annual face-to-face meeting, with the next meeting due to take place in April 2016 in Atlanta, USA (hosted by the American Cancer Society). It publishes regular analyses of the database and evaluation reports and the most recent analysis will be due out soon – check the ICRP website (below) for further details. It also undertakes ad hoc projects where its partners feel there is potential to add value e.g. the group are currently exploring the potential of ÜberResearch (a new science funding software on the market) to perform automated coding of data and reduce the amount of resource devoted to coding funding data prior to analysis.

Key issues and trends within cancer research and beyond

In addition to updates and discussions around our core activities, the 2016 NCRI Winter Meeting provided an opportunity for guest speakers to update attendees on current issues and trends within cancer and the wider field of research. A summary of these presentations is given below.

Eight lessons in science funding

Steven Wooding, Senior Research Leader at RAND Europe (a not-for-profit research institute who undertake research and analyses projects to better understand and improve policy and decision-making in a number of areas) presented an overview of their recently published report, A ‘DECISIVE’ approach to research funding: Lessons from three Retrosight studies. It draws on the findings of three RAND Europe studies to outline key observations and recommendations for policymakers and research funders to maximise the impact of biomedical and health research funding, many of which may be relevant to cancer research.

Consumer and industry representatives are key NCRI stakeholders – ensuring expertise and perspectives are shared across the breadth of the research community. Richard Stephens, NCRI’s Consumer Lead, updated meeting attendees on the latest work of the NCRI Consumer Forum. This included a successful Dragon’s Den event and research poster presentations at the 2015 NCRI Cancer Conference. Virginia Acha, ABPI’s Executive Director – Research Medical and Innovation Insights, provided an update on some of the upcoming areas of focus for the ABPI, including: work with the Health Research Authority on a single approval process for clinical trials; opening dialogue with relevant stakeholders around issues with insurance (e.g. travel insurance) for patients participating in clinical trials; considering evolving science and technologies and the impact on clinical trial design and regulation.

Cancer Taskforce

The Independent Cancer Taskforce, established in January 2015 by NHS England to develop a five-year strategy for cancer services, published its report Achieving world-class cancer outcomes: a strategy for England 2015-2020 last July. It sets out 96 recommendations for improving cancer outcomes. The important role that research has to play featured strongly in the report and Sean Duffy, National Clinical Director for Cancer at NHS England, joined meeting attendees to discuss ways that NCRI are working with Partners, NHS England and the wider research community to drive the relevant recommendations forward. NCRI will be further scoping out the recommendations in the coming months and working with stakeholders to identify next steps.

In November last year the government announced a Spending Review setting out how £4 trillion of government money will be allocated over the next five years. This has implications for many key areas, including health and research. Emma Greenwood, Head of Policy Development at Cancer Research UK, outlined the implications of this on cancer research (Cancer Research UK have previously blogged about the Spending Review – see link below). In summary, it presented a mixed picture for cancer, with protected or increased budgets for health and science but local services delivering public health being required to make savings. For NCRI it will be important to understand how the review impacts on cancer research as further details emerge.

Taking NCRI in to the next decade

NCRI will soon kick-off the process of developing its next five-year strategy, 2017–2022, and meeting attendees discussed the process. Over the next year the NCRI Executive will, in consultation with representatives from NCRI Partner organisations, NCRI Trustees and key stakeholders, look at how we can achieve most impact and develop a strategy that has defined outcomes and measures of success.